MORPHOLOGY
CLINICAL COMPLICATION
EGG
round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Cysticercus bovis
It contains a invaginated protoscolex with 4 suckers but no hooks. The cyst is filled with fluid & the outer wall has villi. ADULT
PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces Inspection of beef for cysticerci Refrigeration of beef for > 24 hours in deep freeze Thoroughly cooking of beef DIAGNOSIS Gravid proglottid in stool. Count number of main lateral arm of uterus Perianal swabbing with cellophane tape for ova TREATMENT Praziquantel,
beef tapeworm infection taeniasis Diarrhea Abdominal cramps Acute intestinal obstruction due to tangled worms Appendicitis due to gravid proglottid lodging into appendix Inflammation of mucosa due to attachment of scolex Nausea, headache, alteration of appetite. These symptoms may be due to toxic products of worms or are allergic reactions
Scolex: 4 prominent round suckers. No rostellum or hooks present Neck: immature proglottids Mature Proglottids: full set of functioning male & female reproductive organs.Follicular testes scattered ant.-dorsal part of proglottid.Genital pore situated irregularly on alternate lateral margins
EGG
INTERMEDIATE HOST Pig & man (larval stage -Cysticercus cellulosae) MOT
round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Cysticercus cellulosae
PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces
opaque invaginated protoscolex with 4 suckers & 2 rows of hooks inside a fluid filled bladder (cyst)
Inspection of pork for cysticerci Refrigeration of beef for > 24 hours in deep freeze Thoroughly cooking of pork
Cysticercus cellulosae Cyst in brain cerebral cysticercosis causes tumour,meningitis, encephalitis, hydrocephalus. In eyes can cause blurring of vision, atrophy of retina, intraorbital pain & loss of vision Spinal cord may cause nervous manifestations -epilepsy/ convulsion/ headache
CESTODE
MORPHOLOGY
CLINICAL COMPLICATION
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ADULT
Scolex: 4 suckers, with double row of alternating large & small hooklets numbering from 22-32 Rostellum present Mature segment: roughly square in shape (12 x 10 mm) almost identical to Taenia saginata
DIAGNOSIS Stool examination Scotch- tape method Examine gravid segment (proglottid) injected with Indian ink & look for the uterine branches TREATMENT Praziquantel,
Hymenolepis Nana (dwarf tapeworm) (cerocystis or cysticercoid larva or the infective eggs) Small intestine
EGG
INTERMEDIATE HOST Fleas & beetles MOT swallowing the infective intermediate host containing cerocystis or cysticercoid larva or the infective eggs PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces DIAGNOSIS stool examination for eggs TREATMENT Praziquantel,
Enteritis abdominal disturbances, loss of appetite, anorexia, vomiting, periodic diarrhoea & dizziness, restless, irritable Pruritus of nose & anus
oval or globular has two membrane enclosing a hexacanth embryo with 6 hooklets. Inner membrane has 2 polar thickenings from each arise 4-8 slender polar filaments Cysticercoid larva
No cyst wall and no bladder filled cavity Solid with invaginated protoscolex
ADULT
Scolex: has 4 suckers with a retractile rostellum with a single row of hooks
Mature proglottids: 4 times as broad as long, with a single genital pore on its left side, three round testes &bilobed ovary
CESTODE
MORPHOLOGY
CLINICAL COMPLICATION
Hymenolepis Diminuta (rat tapeworm) (cerocystis or cysticercoid larva or the infective eggs) Small intestine
EGG
INTERMEDIATE HOST
No polar thickening and no filament Hexacanth embryo (oncospheres) contains six hooks
MOT swallowing the infective intermediate host containing cerocystis or cysticercoid larva or the infective eggs PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces DIAGNOSIS stool examination for eggs TREATMENT Praziquantel,
Hymenolepiasis diarrhoea, loss of appetite mild digestive upset, pain in the stomach/ nervous disorder due to absorption of worms metabolites
Cysticercoid larva
No cyst wall and no bladder filled cavity Solid with invaginated protoscolex
ADULT
Scolex: club shaped has a rudimentary unarmed rostellum without hooks & 4 small suckers
Mature proglottids: 4 times as broad as long, with a single genital pore on its left side, three round testes &bilobed ovary
Diphyllobothrium Latum (plerocercoid larva) small intestine especially in ileum & jejunum
INTERMEDIATE HOST
Golden brown in colour Inconspicuous operculum on one end & a small knob like thickening at the other end Ovum is unsegmented when passed out
1st intermediate host: Copepod (Cyclops) harbour procercoid larva 2nd intermediate host: fresh water fish harbour plerocercoid larva/ spargana
ADULT
MOT is ingested by the 2nd intermediate host which is a fresh water fish PREVENTION avoid eating raw or improperly cooked fish
Scolex: almond shape with two deep dorsoventral sucking grooves called bothrium Mature segments: are broader than long. The dark rosette coiled uterus in the middle of mature proglottids are characteristic.
Diphyllobothriasis Bothriocephaliasis fish tapeworm infection broad tapeworm infection Intestinal obstruction (bolus) due to its length or presence of several adult worms Digestive symptoms such as hunger pain, epigastric fullness/ loss of appetite/ anorexia/nausea/vomiting Symptoms are attributed to absorption of toxic secretions or byproducts of the worm/ irritation caused by the worm Causes pernicious hypochromic type of anaemia because the worm competes for Vitamin B12 that is also ingested by the worm .
CESTODE
MORPHOLOGY
CLINICAL COMPLICATION
EGG
round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Hydatid cyst ( in mucosa + blood stream )
MOT Eggs passed out are immediately infective to the intermediate host DIAGNOSIS X-ray, Ct scan, Ultrasonography Serology: IFA, ELISA, IHA Casoni test: 0.2 ml of fresh hydatid fluid is injected, if positive a wheal develops about 5 mm within hr. Compare with saline Examine sputum for protoscolices/ hooks
Slow growth of cyst increases pressure on the surrounding tissues which resembles a tumour 66% in liver 22% in lungs 3% in kidneys 2% in bones (osseous hydatid cyst) 15% in brain 65 in other tissues/organs (eye, heart, spleen, muscles) Incubation period is about 5 years except in brain and the orbit Anaphylactic shock if cyst is damaged & there is a leakage
ADULT
Scolex: with 4 suckers. Non Retractable rostellum with two rows of hooks Proglottids: 3-5 segments (usually 3)
1st segment is immature 2nd segment is mature segment, 3rd segment is gravid segment